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Comparative Study
. 2021 Jan 21;21(1):49.
doi: 10.1186/s12893-021-01061-1.

Use of human fibrin glue (Tisseel) versus suture during transvaginal natural orifice ovarian cystectomy of benign and non-endometriotic ovarian tumor: a retrospective comparative study

Yu-Ying Su #  1 , Yu-Shan Lin #  1 , Lan-Yan Yang  2 , Yu-Bin Pan  2 , Yi-Ting Huang  1 , Cindy Hsuan Weng  1 , Kai-Yun Wu  1   3 , Chin-Jung Wang  4   5
Affiliations
Comparative Study

Use of human fibrin glue (Tisseel) versus suture during transvaginal natural orifice ovarian cystectomy of benign and non-endometriotic ovarian tumor: a retrospective comparative study

Yu-Ying Su et al. BMC Surg. .

Abstract

Background: To evaluate the use of a human fibrin glue (Tisseel) for minor bleeding control and approximation of ovarian defect during transvaginal natural orifice ovarian cystectomy (TNOOC) of benign and non-endometriotic ovarian tumors.

Methods: A total of 125 women with benign and non-endometriotic ovarian tumors who underwent TNOOC between May 2011 and January 2020: 54 with the aid of Tisseel and 71 with traditional suture for hemostasis and approximation of ovarian defect. Surgical outcomes such as length of surgery, operative blood loss, postoperative pain score, and postoperative hospital stay were recorded. Before and immediately (10 days) and at 6 months after the procedure, serum anti-Müllerian hormone (AMH) levels were also determined.

Results: Complete hemostasis and approximation of ovarian defect were achieved in all cases. No significant difference was noted in the operating time, operative blood loss, postoperative pain scores after 12, 24 and 48 h, length of postoperative stay, and baseline AMH levels between the two groups. The operation did not have a negative effect on the immediate and 6-month postoperative AMH levels in the suture group. However, the decline in the AMH levels was significant immediately after surgery in the Tisseel group, nevertheless, no significant difference was noted in the AMH levels at 6 months (3.3 vs. 1.7 mg/mL; p = 0.042, adjusted p = 0.210).

Conclusion: The use of Tisseel in TNOOC of benign and non-endometriotic ovarian tumors without suturing the ovarian tissue is clinically safe and feasible.

Keywords: Adnexal mass; Cystectomy; Laparoscopy; Tisseel; Transvaginal natural orifice surgery.

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Conflict of interest statement

All the authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Transvaginal ultrasonography showing a well-defined solid tumor (arrow) measuring 9.49 × 5.39 cm in the right adnexal area. b Intraoperative images showing the transvaginal natural orifice transluminal endoscopic portal. c Tisseel is applied on the inner ovarian surface defects with a dual lumen applicator. d The ovarian defect is approximated with an atraumatic forceps for 3 min
See this image and copyright information in PMC

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